| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
37,848 |
34,771 |
$1.94M |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
23,745 |
18,405 |
$1.68M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,339 |
15,128 |
$1.13M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
11,792 |
11,177 |
$314K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,111 |
1,975 |
$182K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,990 |
1,924 |
$181K |
| D1206 |
Topical application of fluoride varnish |
4,487 |
4,276 |
$145K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,860 |
1,090 |
$142K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,630 |
4,110 |
$141K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,864 |
2,402 |
$107K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,421 |
1,269 |
$101K |
| D0120 |
Periodic oral evaluation - established patient |
2,849 |
2,724 |
$90K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
920 |
864 |
$88K |
| D1120 |
Prophylaxis - child |
2,019 |
1,920 |
$85K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13,654 |
12,653 |
$82K |
| D1110 |
Prophylaxis - adult |
1,594 |
1,521 |
$67K |
| D1351 |
Sealant - per tooth |
2,451 |
462 |
$50K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
508 |
463 |
$40K |
| D0220 |
Intraoral - periapical first radiographic image |
3,994 |
3,747 |
$34K |
| D0274 |
Bitewings - four radiographic images |
1,370 |
1,310 |
$30K |
| D0230 |
Intraoral - periapical each additional radiographic image |
5,055 |
3,358 |
$29K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
228 |
224 |
$28K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
558 |
308 |
$27K |
| 99215 |
Prolong outpt/office vis |
183 |
173 |
$23K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
470 |
332 |
$22K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
270 |
221 |
$21K |
| D0272 |
Bitewings - two radiographic images |
1,166 |
1,107 |
$19K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
504 |
360 |
$18K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit |
164 |
128 |
$16K |
| D0190 |
|
1,041 |
1,012 |
$14K |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
112 |
99 |
$14K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,779 |
2,686 |
$12K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
555 |
421 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
260 |
246 |
$8K |
| 90686 |
|
6,112 |
5,868 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
498 |
468 |
$7K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
153 |
133 |
$6K |
| 90834 |
Psychotherapy, 45 minutes with patient |
125 |
96 |
$6K |
| 3074F |
|
12,723 |
11,483 |
$5K |
| 92551 |
|
5,303 |
5,012 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
128 |
118 |
$4K |
| D9993 |
|
390 |
352 |
$4K |
| D1354 |
|
280 |
46 |
$3K |
| 99384 |
|
27 |
27 |
$3K |
| 99381 |
|
42 |
26 |
$3K |
| D7140 |
Extraction, erupted tooth or exposed root |
54 |
38 |
$2K |
| 86703 |
|
295 |
248 |
$2K |
| 99382 |
|
17 |
17 |
$2K |
| D0603 |
|
2,735 |
2,605 |
$2K |
| 82962 |
|
1,688 |
1,611 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
14 |
$1K |
| 99383 |
|
15 |
15 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$1K |
| 90461 |
|
84 |
64 |
$1K |
| 97802 |
|
180 |
163 |
$1K |
| 83655 |
|
137 |
131 |
$984.47 |
| 90651 |
|
281 |
267 |
$866.56 |
| 85018 |
|
537 |
502 |
$785.38 |
| 90677 |
|
542 |
455 |
$737.90 |
| 97803 |
|
27 |
20 |
$647.79 |
| 96156 |
|
12 |
12 |
$592.09 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
1,740 |
1,531 |
$523.09 |
| 81025 |
|
126 |
117 |
$505.10 |
| 81003 |
|
441 |
414 |
$472.53 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
46 |
44 |
$466.46 |
| 90785 |
|
39 |
26 |
$424.80 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$386.90 |
| 3078F |
|
10,768 |
9,755 |
$350.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
32 |
$280.99 |
| D0145 |
Oral evaluation for a patient under three years of age |
13 |
12 |
$255.84 |
| D0270 |
|
25 |
24 |
$212.22 |
| 90656 |
|
360 |
339 |
$179.58 |
| D0602 |
|
316 |
285 |
$167.00 |
| 3075F |
|
155 |
146 |
$75.00 |
| 82044 |
|
17 |
15 |
$38.06 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
7,733 |
7,258 |
$16.00 |
| D0601 |
|
15 |
14 |
$8.00 |
| 4010F |
|
33 |
30 |
$0.01 |
| 3066F |
|
17 |
14 |
$0.01 |
| 2000F |
|
19,066 |
17,151 |
$0.00 |
| 3008F |
|
17,252 |
15,486 |
$0.00 |
| 2001F |
|
9,788 |
8,753 |
$0.00 |
| 3079F |
|
1,657 |
1,524 |
$0.00 |
| D1320 |
|
1,502 |
1,432 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
910 |
708 |
$0.00 |
| D1330 |
|
5,738 |
5,445 |
$0.00 |
| 90680 |
|
485 |
452 |
$0.00 |
| 90647 |
|
759 |
701 |
$0.00 |
| D1310 |
|
5,854 |
5,571 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
29 |
26 |
$0.00 |
| 90723 |
|
935 |
865 |
$0.00 |
| 4037F |
|
360 |
339 |
$0.00 |
| 4060F |
|
504 |
325 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
217 |
163 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
23 |
14 |
$0.00 |
| 4293F |
|
96 |
86 |
$0.00 |
| 3265F |
|
52 |
42 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |
| 90716 |
|
14 |
13 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
22 |
21 |
$0.00 |
| 1160F |
|
18,882 |
16,727 |
$0.00 |
| 3028F |
|
23,054 |
20,421 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
11,069 |
10,213 |
$0.00 |
| 3725F |
|
10,147 |
9,157 |
$0.00 |
| 99173 |
|
6,604 |
6,259 |
$0.00 |
| 1159F |
|
18,882 |
16,727 |
$0.00 |
| 90670 |
|
876 |
848 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
704 |
645 |
$0.00 |
| 4040F |
|
643 |
554 |
$0.00 |
| 4148F |
|
43 |
39 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
149 |
144 |
$0.00 |
| 2028F |
|
75 |
68 |
$0.00 |
| 90633 |
|
229 |
220 |
$0.00 |
| 4274F |
|
359 |
338 |
$0.00 |
| 90662 |
|
84 |
47 |
$0.00 |
| 90734 |
|
132 |
128 |
$0.00 |
| 99051 |
|
65 |
63 |
$0.00 |
| 3045F |
|
14 |
14 |
$0.00 |